Healthcare Provider Details

I. General information

NPI: 1245469261
Provider Name (Legal Business Name): RENAISSANCE ADULT DAY HEALTH CARE CENTER AT CLARIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2009
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 M ST NW
WASHINGTON DC
20005-5176
US

IV. Provider business mailing address

8945 N WESTLAND DR STE 304
GAITHERSBURG MD
20877-1249
US

V. Phone/Fax

Practice location:
  • Phone: 240-506-6846
  • Fax: 888-584-7137
Mailing address:
  • Phone: 240-506-6846
  • Fax: 888-584-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. VALERYA LERA BALANNIK
Title or Position: PARTNER
Credential:
Phone: 240-506-6846